Economists call for addressing healthcare sector’s limitations exposed by Covid-19

Economists have urged the authorities concerned to take the necessary steps to overcome Bangladesh's health sector's shortcomings that have been brought to light during the recent novel coronavirus crisis.

They made the statement at the 3rd Bangladesh Economics Summit on Saturday.

In light of the ongoing Covid-19 pandemic, the Economics Study Center (ESC) launched its report titled, "Assessing the Fault lines of the Health Sector: Implications for Future Policy Response" at the event.

A subsequent panel discussion was held to discuss the findings of the report which was chaired by Dr Rumana Haque, economics professor at Dhaka University. Planning Minister MA Mannan attended the event as its chief guest.

Dr Rumana Haque initiated the session by mentioning the many successes of the Bangladeshi healthcare system throughout history – in the areas of child vaccination, the widespread establishment of community clinics, the reduction of child and maternal mortality – and how they stand in contrast with how the healthcare sector had struggled to handle the pandemic, and the many flaws it has exposed.

She also highlighted many of the public healthcare sector's limitations such as limited budget allocations and high out-of-pocket expenditures for patients; emphasising the need to address these issues.

Sheikh Rafi Ahmed, secretary of Public Relations, ESC, then proceeded to present its report highlighting that even though the healthcare system of Bangladesh has been plagued with problems like poor quality of service, high out-of-pocket expenditures, understaffing, administrative corruption, and mismanagement, the ongoing Covid-19 pandemic had exposed these fault lines and brought many other issues to light.

After conducting a qualitative study on this issue comprising seven doctors and four patients as its case studies, Sheikh Rafi Ahmed highlighted the key findings of the study.

The surveyed doctors talked about their struggles: receiving medical education, improvising alternative medical solutions due to a lack of medical equipment, being overwhelmed by an influx of patients without proper PPE and facilities, dealing with an administration that lacked medical experience, and often suffering from Covid-19 while handling patients.

Similarly, the surveyed patients who had received treatment during the pandemic revealed that they struggled to find available beds at hospitals, faced poor treatment from medical support staff, had to pay for expensive medicine, and were often neglected by proper healthcare services if they lacked proper connections.

Planning Minister MA Mannan responded to the report by acknowledging the importance of addressing the issues plaguing the healthcare sector and emphasising the necessity of everyone, including himself, doing their part to revamp the healthcare sector.

He also acknowledged that despite the strides made by the sector in the past, there are still many irregularities and deep-rooted problems – related to corruption, embezzlement, misappropriation of limited resources, and the disparity between doctors and administrative officers – that continue to hold the healthcare sector back.

Finally, in response to a question regarding the government's initiative to achieve universal healthcare, Mannan said although the internal problems of the healthcare sector are a major obstacle to achieving this goal, the political landscape of the country plays a significant role as well.

Dr Taufique Joarder, research director, FHI 360 in Bangladesh, emphasised the need for defined career tracks for public health officials so that the healthcare sector improves at taking preventive measures for future virus outbreaks and diseases.

He elaborated that there are no defined career tracks for public health, and those who are in charge of it tend to lack the administrative and planning skills necessary to handle such a massive crisis effectively as they often come from clinical backgrounds.

Dr Muhammad Shahadat Hossain Siddiquee, professor, Department of Economics, University of Dhaka, discussed the healthcare sector's inefficient utilisation of funds due to corruption and mismanagement highlighting the lack of proper governance and accountability of the public healthcare system.

He also emphasised the need to fix regional inequalities in the quality of healthcare as well as the need to address non-communicable diseases such as diabetes, heart disease that a significant part of the population continues to suffer from.

Dr Syed Abdul Hamid, professor, Institute of Health Economics, University of Dhaka, focused on the need for proper short and long term planning concerning the healthcare sector so that impromptu or ad hoc solutions do not have to be devised when it is caught unprepared.

He also talked about the need to establish separate career paths for healthcare professionals who want to teach, run clinics, join administration or public health. He argued, "We need to be able to make health-related decisions that are not international donor-driven since we are less dependent on them to finance our healthcare."

Finally, he emphasised on the need to establish a permanent healthcare watchdog called the National Healthcare Commission (NHC) which could oversee the long term development of the healthcare sector.

Dr Rumana Haque concluded the session saying that the pandemic has reminded us of our limitations in the healthcare sector, and it has caused a renewed interest in: ensuring accountability to prevent embezzlement and corruption, establishing separate career tracks for public health, establishing an NHC to develop the health sector in a planned manner, and decentralising power and responsibility on a regional level to promote healthcare equality.